The Maltese cross, in Italy also known as the Amalfi cross, is the cross symbol associated with the Knights Hospitaller (the Knights of Malta) and by extension with the island of Malta. The cross is eight-pointed and has the form of four "V"-shaped elements, each joining the others at its vertex, leaving the other two tips spread outward symmetrically. Its design is based on crosses used since the First Crusade. It is also the modern symbol of Amalfi, a small Italian republic of the 11th century.

In the mid 16th century, when the Knights were at Malta, the familiar design now known as the "Maltese Cross" became associated with the island. The first evidence for Maltese Cross on Malta appears on the 2 Tarì and 4 Tarì Copper coins of the Grand Master Jean Parisot de Valette (Grand Master 1557–1568). The 2 and 4 Tarì Copper coins are dated 1567. This provides a date for the introduction of the Maltese Cross.[1]

The Maltese cross was depicted on the two mils coin in the old Maltese currency and is now shown on the back of the one and two Euro coins, introduced in January 2008.[2]

Maltese cross

The insignia of a Serving Brother of the Most Venerable Order of the Hospital of Saint John of Jerusalem

In the 15th century, the eight points of the four arms of the later called Maltese Cross represented the eight lands of origin, or Langues of the Knights Hospitaller: Auvergne, Provence, France, Aragon, Castille and Portugal, Italy, Baviere (Germany), and England (with Scotland and Ireland).[3]

The eight points also symbolize the eight obligations or aspirations of the knights:[3]

Tactful (“that he may without thoughtless questions learn the symptoms and history of the case, and secure the confidence of the patients and bystanders”)

Resourceful (“That he may use to the best advantage whatever is at hand to prevent further damage, and to assist Nature’s efforts to repair the mischief already done”)

Dextrous (“that he may handle a patient without causing unnecessary pain, and use appliances efficiently and neatly”)

Explicit (“that he may give clear instructions to the patient or the bystanders how best to assist him”)

Discriminating (“that he may decide which of several injuries presses most for treatment by himself, what can best be left for the patient or bystanders to do, and what should be left for the medical men”)

Persevering (“that he may continue his efforts, though not at first successful.”)

Sympathetic (“that he may give real comfort and encouragement to the suffering”)

The Maltese cross is used to identify the final approach fix in a non-precision instrument approach (one that lacks precision vertical guidance), in contrast to the use of a lightning bolt type icon, which identifies the final approach fix in a precision approach.

The Maltese cross is a national symbol of Malta and is displayed as part of the Maltese civil ensign. The Maltese euro coins of one and two euro denomination carry the Maltese cross. It is also the trademark of Air Malta, Malta's national airline.

In medicine, the disease Babesiosis is recognized by the tetrad form that the parasite takes inside red blood cells. This is often referred to as a "maltese cross" sign because of the resemblance of the tetrad to the cross on peripheral blood smear.

In Norway, the Maltese Cross is the symbol used in the Order of St. Olav. Det Norske Veritas uses the Maltese Cross as symbol in the class notifications telling that the ship is constructed under their monitoring.

In the Philippines, the Maltese cross is part of the school seal of Colegio de San Juan de Letran. It was founded by Don Juan Alonso Jeronimo Guerrero, a retired Spanish officer and one of the Knights of Malta and Fray Diego de Santa Maria, O.P., a Dominican brother. It is also a part of the pendant of the Quezon Service Cross, which is the highest honor that can be conferred in the Republic.[5]

In Sweden a Maltese Cross forms the basic form for all the royal orders of merit, The Orders of the Seraphim, Sword, North Star and Vasa. Also the Maltese Cross is used by the Swedish Mounted Royal Guards as their coat of arms. The Swedish municipality of Mönsterås also uses a Maltese Cross on its arms.

It is the symbol of the Royal Shrewsbury School Boat Club, displayed on the oars and uniform of the 1st VIII.

It is a symbol used by the ATOC on rail tickets which allow travel on the London Underground between London Rail Terminals (e.g., between Euston and Victoria), when passengers are travelling via London. Alternatively, where the destination of the ticket is a London Travelcard Zone, the inclusion of the cross allows a passenger to undertake one single or return journey to any station within that Zone from the London Terminal station at which they arrived.

It is used by the St John Ambulance organisation as their main form of identification.

The Cross is also one of the symbols of Rosslyn Park FC, a rugby club in London, England.

The Maltese cross flower (Lychnis chalcedonica) is so named because its petals are similarly shaped, though its points are more rounded into "heart"-like shapes. The flower Tripterocalyx crux-maltae was also named for the Maltese cross.[7] The Geneva drive, a device that translates a continuous rotation into an intermittent rotary motion, is also sometimes called a "Maltese cross mechanism" after the shape of its main gear.

A variant of the Maltese cross, with three V-shaped arms instead of four, was used as the funnel symbol of the Hamburg Atlantic Line and their successors German Atlantic Line and Hanseatic Tours in 1958–1973 and 1991–1997. A five-armed variant is the "Cross" of the French Legion of Honour(Croix de la Légion d'honneur). A seven-armed variant known as the "Maltese asterisk", is used as the basis of Britain's Order of St Michael and St George.

Other crosses with spreading limbs are often mistakenly called "Maltese", especially the cross pattée. The official symbol of the Alpha Tau Omega fraternity is the cross pattée, though the organization's founder thought it was a Maltese cross when the organization was formed in 1865. The Nestorian cross also is very similar to both of these.